There is growing evidence that tobacco smoking is an important risk factor for tuberculosis (TB). India, with a population of 1.26 billion, has the highest number of both TB patients and smokers. The convergence of these two important health hazards is likely severely affecting India's TB control programs. This study was carried out to determine the prevalence of smoking in newly diagnosed pulmonary TB patients and the impact of smoking on disease outcomes in a tertiary care hospital. All patients newly diagnosed with pulmonary TB as per the Revised National Tuberculosis Program of India (RNTCP) 2013 criteria were enrolled in the study. On the basis of their self-reported smoking status, the participants were classified as never smokers, current smokers, and ex-smokers. Patients were started on anti-TB treatment and were followed for 2 years. Among the 2350 subjects (1,758 males and 592 females), 1,593 patients (67.78%) were never smokers. Current and ex-smokers numbered 757 (32.21%), of which 751 (31.95%) were males and 6 (0.26%) were females. Smoking was associated with more extensive lung disease, lung cavitation, and positive sputum smear and culture results at baseline. In both current smokers and ex-smokers, sputum smears and cultures were significantly more likely to remain positive after 2 months of treatment. Ex-smokers and current smokers had significantly high rates of defaults, treatment failures, and relapses. The prevalence of smoking is very high in TB patients. Tobacco smoking is associated with a considerably increased risk of advanced and more severe disease in the form of lung cavitations, positive sputum smear and culture results, and slower smear and culture conversion after initiation of treatment. Smoking has a great negative effect on treatment completion, cure rates, and relapse rates in patients with pulmonary TB.

Background:Chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) are common and under diagnosed medical conditions in India. Prevalence of these chronic diseases are high both in rural and urban areas. However, exact prevalence of DM in Indian COPD patients in unclear. Co-morbid conditions like DM have great impact on the outcome of COPD in the form of severity, exacerbations, morbidity and mortality. Hence the present study objective was to screen COPD patients for DM.Results:A total of 1662 patients with COPD (Males = 1264, Female = 398) with mean age 58 ± 9.6 were screened for DM. Patients with known history of DM were 353 (21.24%) and were enrolled as Known DM cases. Remaining 1309 (78.76%) patients whose DM status was unclear were screened by random blood sugar (RBS). One-hundred and seventy-one subjects had RBS > 110 mg/dl. About 73 (4.39%) subjects had fasting blood sugar (FBS) > 126 mg/dl. They were considered as Newly Diagnosed DM cases. Total number of DM cases in the study including new and known was 426 (25.63%). Number of patients with deranged FBS (FBS between 110 mg/dl to126 mg/dl) was 84 (5.05%). Among the DM patients with COPD 168 (10.11%) had poor glycemic control with HbA1c > 8. Prevalence of DM in present study was 25.63%.Conclusion:Prevalence of DM in COPD patients in the present study is 25.63% when actively screened in tertiary care hospital. It is feasible and imperative to screen all COPD patients for DM in all health care facilities routinely.

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